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Neisseria gonorrhoae GN diplococci, kidney bean shaped, aerobic, oxidase+, pili, OMPs (Opa or Protein II) surf strx change antigenically, short chain LPS called LOS/Thayer-Martin/Martin-Lewis Selective Media/Chocolate, requires CO2 Pain & purulent dischrge at infected site (urethritis, men/endocervix, wom->PID); highest in wom 15-19; men 20-24; asympt (esp wom); most men have acute symptoms; attack rate 20-50%; rarely spreads (prostate/epidy & fallop); DGI (migrating polyarth/rash) lack of immunity (LOS and Opa proteins) GRAM(GN diplococci bean shaped in PMNs, more sens in men; other bact in wom complicate); CULT(urethral-men/cervical swab-wom); NOTIFY LAB (ML-TM agar), oxidase +; DIRECT:DNA amplification (expensive) THIRD GENERATION CEPHALOSPORINS (ceftriaxone); CIPRO (dev resistance); AZITHROMYCIN (both gon/chlym); Doxycycline (oral 7 days); silver nitrate/erythromycin eye drops for neonates; vaccine development difficult bc of pili antigen variations PID (ectopic preg/sterility); opthalmia neonatorum; metastatic infections can lead to endocarditis/meningitis/purulent arthritis
Chalmydia trachomatis obligate intracellular parasite, trilaminar OM, decr peptido, can't synth ATP (like Rickettsiae), complex life cycle (extracellular metab inactive infectious EB-->met active intracellular RB); EB-->RB intracellularly=cell death; infects columnar epi cells most common STI; most common cuase of NGU (Ureapl urea 2nd); tropism for epithelial cells of endocervix, upper GU (wom), urethra, rectum, conjunctiva; causes PMN and inflamm response, chronic sequelae no reliable protection, All tests req collection of Epi cells, clean away inflamm cells;CULT rarely done, SEROL (common antigen false pos)IMMUN (only endocervix,urethra approved) no LGV or PID or DNA probes, PCR (urine) Erythromycin, Tetracycline, Quinolones (cipro/levo); Inclusion Conjunctivitis (neonates) req systemic Erythromycin thereapy bc of possible colonization; NO B-lactams (??post gonococcal urethritis) Ocular trachoma (CHRONIC follicular keratoconjunctivitis--incr vascularization and scarring of cornea, opaque blindness); transmitted fomites, flies, fluids) genital infection; most common in neonatal conjunctivitis (inclusion conjunctivits--ACUTE);PID
Lymphogranuloma venereum caused by Chlamydia trachomatis strains L1, L2, L3 transient genital lesions followed by multilocular suppurative involvement of the inguinal lymph nodes, primary genital lesion painless/unnoticed; painful inguinal adenopathy primary complaint fevers, chills, HA, arthralgia, and myalgias common, can lead to anal strictures or hemorrhagic proctitis culture the bubo? can't use immunologic bc only okayed for endocervix and urethral secretions Lymphnodes may need to be aspirated to prevent rupture; hemorrhagic proctitis, anal strictures
Haemophilus ducreyi Chancroid; GNR, coccobacillary, require blood media (chocolate agar), smallest bacteria, polysaccharide capsule, require exogenous hematin/NAD (factors X and V) common ds in developing countries, tender papule-->painful ulcer with sharp margin, satelite lesions are autoinfectious, regional lymphadenitis (unilat/bilat inguinal lympad), 1 lesion, rough edge, bigger than HSV, prostitutes, "soft chancre", short incub no immunity due to CYTOLETHAL DISTENDING TOXIN which kills T cells, and ADHESIVE PILI that resist phagocytosis and complement mediated killing gram stain and culture (hard to recover)--coccobacillary, railroad track appearance, CULTURE ceftriaxone, azithromycin, cipro (almost all strains produce Beta Lactamase) Chancroid, increased risk for HIV (CD4 recruitment, open lesion)
Treponema pallidum grows slowly, dry dying, (blank) (blank) Darkfield Microscropy, Immunoflourescence, Silver Impregnation (Warthin-Starry Stain) (blank) ruptured aortic aneurysm, dimentia
Created by: microUMKC